Adult acne requires specialised treatments in Singapore.
Adult acne can be particularly frustrating. It tends to affect women more than men at any age – as fluctuations in hormones in a woman’s monthly cycle, pregnancy, menopause can trigger breakouts.
That being said, men are not spared from adult acne either.
Let’s find out more about the range of effective adult acne treatments in Singapore.
What is adult acne treatment in Singapore?
First and foremost, we need to differentiate acne and a subtype of rosacea – acne rosacea, whilst these two conditions tend to look the same, the treatments are very different. The main differentiating factor will be the lack of a punctum in ‘acne’ rosacea. There are other symptoms like sensitive skin, redness and visible blood vessels that is seen in rosacea but not in acne. If you are still not sure, a detailed examination by a doctor is usually sufficient to diagnose the correct condition.
Every hair follicle is coupled with an oil gland, which secrete sebum via pores to protect and lubricate the skin. When the pores are clogged with sebum or dead skin cells, comedones form, commonly presenting as whiteheads/blackheads. Inflamed and infected acne can result in pus-filled lesions, in increasing size termed – papules, pustules, nodules and cysts.
What causes adult acne in Singapore?
There are known causes for adult acne and other related risk factors weakly linked to aggravate acne. A detailed history taking can sometimes identify the cause (if any), but in many cases, we just simply cannot put a finger to it.
If there is a known cause, treating the cause will be the most direct and cost effective way.
Hormones – this is the most proven single factor that triggers adult onset acne. Testosterone surge in puberty and high levels of testosterone in medical conditions like PCOS can worsen acne. Fluctuating hormone levels, particularly falling estrogen levels, relating to pregnancy,menstrual cycle and menopause makes women more susceptible to breakouts!
Medications – certain medications that containing corticosteroids, testosterone or lithium can aggravate acne.
Stress – it is difficult to quantify stress levels but there are several studies that strongly link stress as a provoking factor.
‘Heatiness’ – Your traditional Chinese medicine doctor will probably tell you acne is caused by heatiness (like how every other condition is linked to heatiness). Despite the lack of prove that heatiness actually exist, there are still many firm believers of our traditional medicine. I wouldn’t advice against trying out ‘liang teh’ remedies as they are usually cheap and very safe.
Does diet cause Adult Acne?
Diet – there are so many studies and different school of thoughts on this.
Meat, chocolate, greasy food, diary has very little evidence to prove any link to cause acne. However there is increasing evidence suggesting that acne is a metabolic syndrome of the skin linked to excess intake of carbohydrates.
Review of Adult acne treatments in Singapore
Always, do not underestimate the simple things you can do to improve acne. Using mild exfoliating cleansers containing AHA helps to control oil glands and prevent the build-up of dead skin cells in the pores. Avoid harsh scrubs as these commonly aggravates the condition by affecting the natural healing of the skin by scrubbing away the scabs, causing delayed healing.
Products containing ceramide helps with healing and niacinamide (Vitamin B3) helps to lighten acne marks and oil control. Light duty peels should be considered in your daily skincare routine. Retinols are weakly peeling and can increase the turnover of the skin. Benzoyl peroxide creams that are readily available in pharmacies work by penetrating the pores and kills the acne-causing bacteria with oxygen. Salicylic acid cleansers and formulated creams effectively dries up pimples and remove dirt, oil and dead skin clogging up the pores.
Facial treatments in beauty salons can be helpful especially for mild acne, but only in the right hands. Rather than trying your luck at beauty salons, you may want to go for a medical facial like hydrafacial which uses three actions that contribute to the resurfacing of the skin, physical exfoliation from water pressure and a textured tip, chemical exfoliation from acids, and suction to left dead skin off the surface. Other devices like microcurrents, high frequency or LED light therapy can used to for bactericidal effects.
Hydrafacial is a medical-grade machine that delivers a very controlled treatment, so there is very minimal injury to the skin and some people in the states call it the ‘magic facial’. There are many ‘copy-cat’ machines claiming to be Hydrafacial. You might want to verify that before starting any treatment.
For moderate to severe acne, you should seek medical advice promptly for best outcomes as more aggressive treatments may be warranted.
Prescription creams – a common prescription topical retinoid cream that we prescribe is Retin-A. it works by thinning out the skin, thereby reducing the formation of comedones. This has been a mainstay of acne treatment in the last 25 years. Other topical retinioids like Differin (Adapalene) and Tazarotene are also labelled by the FDA for the treatment of moderate acne. As vitamin A is ‘lipophilic’, there is potential dermal absorption and is not recommended for pregnant woman.
Antibiotic creams like erythromycin and clindamycin are the most commonly used bactericidal agents that work directly by killing the acne-causing bateria – P.acnes. Prescription creams are ‘prescriptions’ for a reason as there are risk involved like irritation to the skin, the possibility of burns especially on darker skin tone patients, developing photosensitivity and teratogenic properties. It is important to make sure to consult and the prescription cream is useful for your type of acne at its correct concentrations.
There are different kinds of peels with different concentrations and formulations. Generally salicylic acid peels are very good to ‘clean-up’ the skin by penetrating comedones ad pores to prevent clogging and neutralizes bacteria with its lipophilic properties. It has also well documented anti-inflammatory properties. Jessners’ Peel is also a peel that we commonly use for acne treatment. It is a the combination peel – 14% SA , 14% resorcinol and 14% LA in 95% ethanol. Each active ingredient has its unique mechanism of action and this combination is very effective for acne treatment too. The type of peel used will be determined after assessment of your skin as some peels are more useful for infected acne, while some are better for PIH (acne marks).
Laser therapy is increasingly popular in the treatment of active acne, especially when the abovementioned treatments have failed to work or showed slow progress. Increasing number of studies have shown promising results in the treatment of acne with laser. However, more research and studies are warranted as there is no consensus in a specific laser best for acne.
In my practice, I have seen good improvements with PicoPlus laser, with the different settings, and multiple lenses and multiple wavelengths are available so we can treat the different stages of acne. For example, gold toning emits light at 595nm which is reduces inflammation and redness, while the dual focus lens allows a deeper penetration which treat acne scarring.
However, it is not without its limitations. Results vary from person to person. General improvements are seen in most patients, but some may require more session than the others to see the same extent of improvement.
Steroid injection instantly reduces inflammation caused by an infective cystic acne. Although this is not a standard treatment for acne, it is reserved for the most desperate times for example. when your wedding is in the next few days! It is true that the SAME acne can clog and become infected again, the instant relieve is a lifesaver for many people! We also offer this injection as we believe that by reducing the inflammation, it reduces the risk of bad scarring and PIH with an acne with increasing in size. This is especially useful for adult acne as they tend to be more cystic and deeper.
Oral antibiotics are commonly prescribed to reduce bacteria and fight inflammation. They are very useful for cystic breakouts in adult acne. Combined oral contraceptives are approved by the FDA for acne treatment for women who also wish to use them for contraceptive purposes. However, this is a less popular choice as the side effects of weight gain, breast tenderness and nausea are not very well tolerated. Anti-androgen medications like Aldactone, blocks the action androgen hormones on the sebaceous glands. Oral isotretinoin is THE fool proof medication that works on the most severe form of acne that does not respond to other treatments. It is generally very safe but potential side effects, like birth defects, liver failure, depression etc., can be very serious and should only be prescribed and monitored by your doctor.
Tip – Whatever it is DO NOT PICK on acne! I find it very difficult myself not to pick on this irritating dried scab on a healing acne. However, picking it can cause the bacteria to spread and more acne vulgaris to form. It also increases the risk of permanent scarring by prolonging the ‘scabbing’ phase.
Is there a permanent treatment for adult acne?
Unfortunately, there isn’t a magic potion available. Let me explain. Whilst there are effective treatments that treat acne – i.e. the bumps and marks, allowing them to heal faster, new ones can crop up as the skin is a living organ and clogged pores can accumulate again. Therefore, some maintenance will be required even after all your active acne issues resolve. When I say maintenance, it can be just complying to a skin care routine! But by abruptly stopping treatments or medications can result in a rebound especially in acne-prone skin.
When can I see results of adult acne treatment in Singapore?
No “quick fix” is available. Expect to see improvements 4-6 weeks with oral medications and topical creams, and about 3 sessions for lasers before you decide if a treatment (didn’t) work. Therapy should be continued until new lesions no longer appear.
How is adult acne treatment different from teenage acne?
Adult acne differs markedly from the pimples of your teen years, both in how it appears and how it’s treated. In teenage acne, they tend to appear mostly as tiny superficial blackheads and occasional papules. They are commonly found at the T-zone. Adult acne affects women more than man as hormonal fluctuations with menses, pregnancy and menopause. Adult acne occurs mostly over the chin area and along the jawline. They tend to be deeply indurated and more cystic in nature.
Does adult acne resolve on its own?
As we age, our oil glands get less active and other causes like hormonal changes tend to resolve without intervention. Statistically, for most people, it should resolve.
According to a survey done by dermatologists at the University of Alabama-Birmingham: In their 20s, 50.9% of women and 42.5% of men in their 20s reported experiencing adult acne. The prevalence of adult acne decreases as we age. Even in their 50s, 15.3% of women and 7.3% of men reported experiencing acne
Why should we treat adult acne?
Adult acne can be embarrassing. You don’t need your mother-in-law asking what happened to your face or have an hour of conversation with your boss, who would talk looking at that cystic pimple that cannot be concealed with any makeup.
As we age, our skin turnover slows down. Marks that used to heal within weeks now take months to heal and they don’t heal as well as our ability to stimulate collagen naturally decreases, thereby increasing the risk of forming depressed scars.
When we treat adult acne, we minimise the post-inflammatory hyperpigmentation and risk of permanent scarring, minimising any inconvenience caused to tide you through this phase.
Adult Acne Treatment Price
Adult acne treatments cost from $150 for Pico Laser treatment.
For a detailed treatment plan and price list, please consult an expert medical doctor.